Customer Representative jobs at L.A. Care Health Plan - 31 jobs

Salary Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary Under the general direction of leadership and management in the Customer Solution Center, Call Center, the Customer Solution Center Service Representative III handles provider inquiries and issue resolution of Level One (1) inquiries, this includes but not limited to, general inquiries on claims processing and status and eligibility verification. In addition, this position will provide support as-needed to members on in-bound calls as part of the larger role of "one-stop shop" service in the Customer Solution Center. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties Assist providers in response to telephonic and electronic inquiries and concerns on all products and paid/unpaid claims. Ensure that accurate information is being given to the provider in a timely manner and with the highest level of customer service. Handle Level One (1) provider inquiries this includes (but not limited to): general inquiries on claims processing, payment status and appeal and eligibility status verification. Document the interaction with the provider, including any resolution or escalation steps in the system of record for each call. Provide detailed information for each call including: Caller information; Information related to request/issue; Resolution information or escalation steps. Escalate Level Two (2) provider concerns to the Claims Department for resolution (e.g. Provider Disputes, incorrectly paid claims, payment check status, and Explanation of Benefits (EOB) requests. (50%) Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project's/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.(20%) Support the Call Center in meeting State regulatory requirements by handling member-related inbound calls. (10%) Perform special projects and ad-hoc assignments when necessary. (10%) Perform other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 2 years of experience in customer service in a high-call-volume healthcare customer service call center, including a minimum of 2 years of general claims inquiry or managed care specialty line of business experience. Customer service training in a healthcare environment. Data entry experience with the ability to type a professional minimum of 35 wpm. Skills Required: Working knowledge of Microsoft Office Suite (e.g. Word, Excel, PowerPoint, Outlook). Excellent communication skills (written and verbal). Ability to navigate multiple programs/databases while assisting each caller. Proficient knowledge in healthcare product lines, medical terminology and claims processes. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Preferred: Technical training/certificate in a technical or business school (e.g. medical billing, medical terminology, medical coding, healthcare). Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Customer Service Representative, Call Center Representative, Claims, Medical Coding, Call Center, Customer Service, Insurance, Healthcare

****Premium pay offered for evenings, overnights, weekends, and holidays**** Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** You have high standards. So do we. Here at UnitedHealth Group, this includes offering an innovative new standard for care management. It goes beyond counseling services and verified referrals to programs integrated across the entire continuum of care. That means you'll have an opportunity to make an impact on a huge scale - as part of an incredible team culture that's defining the future of behavioral health care. For this role you must have an active and unrestricted license in your state of residence and you must be able to work nights, weekends and holidays. If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Field inbound calls in a queue from members and providers for purpose of assessment and triage + Focus on initial inpatient admission for psychiatric and chemical dependency patients + Assess patients and determining appropriate levels of care based on medical necessity + Assess and manage member crisis calls + Determine if additional clinical treatment sessions are needed + Manage inpatient mental health cases throughout the entire treatment plan + Identify ways to add value to treatment plans and consulting with facility staff + Attend compliance training and team meeting You'll find the pace fast and the challenges ongoing. We'll expect you to achieve and document measurable results. You'll also need to think and act quickly while working with a diverse member population. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Independent, Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, OR Licensed Ph.D., OR an RN with 2+ years of experience in behavioral health + Residence and licenses must be independent, active and unrestricted in the State of California + Proficient Microsoft skills (Word, Excel, Outlook) + Proven ability to talk and type at the same time and have the ability to navigate between multiple screens + Proven ability to work nights, weekends and holidays according to your schedule **Preferred Qualifications:** + Inpatient experience + Dual diagnosis experience with mental health and substance abuse + Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

****Premium pay offered for evenings, overnights, weekends, and holidays**** Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** You have high standards. So do we. Here at UnitedHealth Group, this includes offering an innovative new standard for care management. It goes beyond counseling services and verified referrals to programs integrated across the entire continuum of care. That means you'll have an opportunity to make an impact on a huge scale - as part of an incredible team culture that's defining the future of behavioral health care. For this role you must have an active and unrestricted license in your state of residence and you must be able to work nights, weekends and holidays. If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Field inbound calls in a queue from members and providers for purpose of assessment and triage + Focus on initial inpatient admission for psychiatric and chemical dependency patients + Assess patients and determining appropriate levels of care based on medical necessity + Assess and manage member crisis calls + Determine if additional clinical treatment sessions are needed + Manage inpatient mental health cases throughout the entire treatment plan + Identify ways to add value to treatment plans and consulting with facility staff + Attend compliance training and team meeting You'll find the pace fast and the challenges ongoing. We'll expect you to achieve and document measurable results. You'll also need to think and act quickly while working with a diverse member population. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Independent, Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, OR Licensed Ph.D., OR an RN with 2+ years of experience in behavioral health + Residence and licenses must be independent, active and unrestricted in the State of California + Proficient Microsoft skills (Word, Excel, Outlook) + Proven ability to talk and type at the same time and have the ability to navigate between multiple screens + Proven ability to work nights, weekends and holidays according to your schedule **Preferred Qualifications:** + Inpatient experience + Dual diagnosis experience with mental health and substance abuse + Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Master's level cleared behavioral health, California License: Licensed Marriage and Family Therapist (LMF), Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), Licensed Professional Counselor (LPC) or Licensed Psychologist for position for the County of San Diego's 24/7 Access and Crisis Line (ACL). The ACL provides free, confidential access to behavioral health services and crisis intervention for the 3.3 million San Diegans. The ACL also provides afterhours pre-authorization for behavioral health inpatient; crisis residential and residential substance use disorder treatment. As the clinical work is done strictly by telephone, text, and chat; this position requires an incredibly unique set of clinical skills more astute than those required for face-to- face interactions as there are no visual cues from which to draw upon to help paint a comprehensive clinical picture. Clinicians need to rely on their graduate education in psychology/sociology or related field, formal clinical training, and experience to exercise discretion and clinical judgment when providing access to appropriate behavior health services and crisis work. Clinicians need to quickly triage calls/chats/texts in the queue to ensure safety and meet contractual performance standards. Must be able to work both independently and collaboratively with high precision and intensity like that of an emergency department- everyone has a crucial, time sensitive task to complete which is integral to the success of the entire operation. This is a fast-paced, clinically heavy position not for the faint of heart but equally rewarding as one can play a pivotal role in someone's journey to recover and save lives. Behavioral Health Access -Mental Health & Substance Use Disorder Treatment Services within San Diego's system of care. ACL clinician needs to quickly establish an emotional connection with the individual, identify their need(s), conduct a behavioral health screening which includes an adapted ASAM (American Substance Abuse Medicine) screening. The clinician will also conduct clinically relevant screenings such as CalAIM (California Advancing & Innovating Medi-Cal) to determine the appropriate level of care; suicide, homicide, and Mobile Crisis Response Team (MCRT). The clinician needs to recognize, properly intervene, and follow up on any risk factors. The clinician will also help provide linkage to the most appropriate type and level of care based on the collective screenings and preferences of the caller/chatter/texter. Crisis Work -Mental or Emotional Distress; Intimate Partner Abuse; Child/Elder Abuse; Suicide prevention, intervention and postvention etc. ACL clinician needs to quickly establish a therapeutic alliance, screen for risk factors, seek to help de-escalate the individual using brief solution focused therapy, motivational interviewing skills and Applied Suicide Intervention Skills Training (ASIST). Clinicians help ensure safety by using the least invasive intervention on a continuum to the most invasive, which may include initializing active rescue services as a last resort. Once de-escalated, clinicians will collaboratively work with the individual to explore the next steps and treatment options. This service meets 988 National Suicide Prevention Lifeline (NSPL) standards for risk assessment and engagement of individuals at imminent risk of suicide. ACL accepts calls from 988 to support individuals in crisis. Utilization Management Afterhours - Review behavioral health pre-authorization documentation for inpatient, crisis residential and residential substance use disorder treatment requests for Medi-Cal beneficiaries. These reviews are completed via an online review process. The documentation is completed in the County's Electronic Health Record (EHR); you must be able to access the County's EHR. A successful clinician must quickly switch between answering access and crisis calls, texts, and chats and process pre-authorizations. Shift is Sat and Sun 4:30am-3pm and Wed and Thurs 6pm-4:30am If you are located in CA, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Uphold and model Our Cultural Values + Adhere to all applicable laws and ethics (HIPAA (Health Insurance Portability and Accountability Act), Exceptions to confidentiality, Reporting Abuse, Duty to Warn etc. + Answer calls/texts/chats within standard service levels + Apply sound clinical judgement and consult with fellow clinical professionals when indicated + Triage calls/chats/texts based on presenting mental health and/or substance use disorder symptoms + Conduct appropriate behavioral health screenings, including ASAM, CalAIM, MCRT, suicide, and homicide (when indicated) + Provide customized, behavioral health referrals using a client centered approach + Conduct crisis work and ensure safety at all costs + Document all interaction in a succinct, clinical manner in the designated database; documentation must adhere to Dept. of Health Clinical Service (DHCS) requirements + Utilize our Central Contact Tracking Database and place Medi-Cal clients on the wait list per contractual guidelines + Ability to access and enter accurate relevant clinical information into Medi-Cal beneficiary electronic health record (EHR) + Meeting individualized performance goals + Complete mandatory ongoing continuing education and cultural training + Problem solves technical issues + Elevate operational issues to the manager + Adapt to changes and maintain flexibility as processes and policies are implemented to ensure compliance and quality standards You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Master's Degree or Doctorate within human services such as psychology, sociology or equivalent + 2+ years of post graduate degree providing direct clinical services: psychosocial assessments, individual therapy, substance use drug/alcohol treatment, case consultation with multidisciplinary team; case management; developing treatment plans with short/long-term goals; maintain confidential files; in-service trainings and discharge planning + Active and clear California License: Licensed Marriage and Family Therapist (LMFT), Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Psychologist and/or LPC. A licensed professional cannot be on probation and/or no pending corrective actions + Experience working with diverse multi-ethnic/socioeconomic populations; myriads of psychological disorders and addictions + Personal Computer (PC) proficiency and self-reports the ability to type with minimum proficiency of 45 words per minute + Able to work Sat and Sun 4:30am-3pm and Wed and Thurs 6pm-4:30am **Explore opportunities at Optum Behavioral Care.** We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment_ .

Master's level cleared behavioral health, California License: Licensed Marriage and Family Therapist (LMF), Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), Licensed Professional Counselor (LPC) or Licensed Psychologist for position for the County of San Diego's 24/7 Access and Crisis Line (ACL). The ACL provides free, confidential access to behavioral health services and crisis intervention for the 3.3 million San Diegans. The ACL also provides afterhours pre-authorization for behavioral health inpatient; crisis residential and residential substance use disorder treatment. As the clinical work is done strictly by telephone, text, and chat; this position requires an incredibly unique set of clinical skills more astute than those required for face-to- face interactions as there are no visual cues from which to draw upon to help paint a comprehensive clinical picture. Clinicians need to rely on their graduate education in psychology/sociology or related field, formal clinical training, and experience to exercise discretion and clinical judgment when providing access to appropriate behavior health services and crisis work. Clinicians need to quickly triage calls/chats/texts in the queue to ensure safety and meet contractual performance standards. Must be able to work both independently and collaboratively with high precision and intensity like that of an emergency department- everyone has a crucial, time sensitive task to complete which is integral to the success of the entire operation. This is a fast-paced, clinically heavy position not for the faint of heart but equally rewarding as one can play a pivotal role in someone's journey to recover and save lives. Behavioral Health Access -Mental Health & Substance Use Disorder Treatment Services within San Diego's system of care. ACL clinician needs to quickly establish an emotional connection with the individual, identify their need(s), conduct a behavioral health screening which includes an adapted ASAM (American Substance Abuse Medicine) screening. The clinician will also conduct clinically relevant screenings such as CalAIM (California Advancing & Innovating Medi-Cal) to determine the appropriate level of care; suicide, homicide, and Mobile Crisis Response Team (MCRT). The clinician needs to recognize, properly intervene, and follow up on any risk factors. The clinician will also help provide linkage to the most appropriate type and level of care based on the collective screenings and preferences of the caller/chatter/texter. Crisis Work -Mental or Emotional Distress; Intimate Partner Abuse; Child/Elder Abuse; Suicide prevention, intervention and postvention etc. ACL clinician needs to quickly establish a therapeutic alliance, screen for risk factors, seek to help de-escalate the individual using brief solution focused therapy, motivational interviewing skills and Applied Suicide Intervention Skills Training (ASIST). Clinicians help ensure safety by using the least invasive intervention on a continuum to the most invasive, which may include initializing active rescue services as a last resort. Once de-escalated, clinicians will collaboratively work with the individual to explore the next steps and treatment options. This service meets 988 National Suicide Prevention Lifeline (NSPL) standards for risk assessment and engagement of individuals at imminent risk of suicide. ACL accepts calls from 988 to support individuals in crisis. Utilization Management Afterhours - Review behavioral health pre-authorization documentation for inpatient, crisis residential and residential substance use disorder treatment requests for Medi-Cal beneficiaries. These reviews are completed via an online review process. The documentation is completed in the County's Electronic Health Record (EHR); you must be able to access the County's EHR. A successful clinician must quickly switch between answering access and crisis calls, texts, and chats and process pre-authorizations. Shift is Sat and Sun 4:30am-3pm and Wed and Thurs 6pm-4:30am If you are located in CA, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Uphold and model Our Cultural Values + Adhere to all applicable laws and ethics (HIPAA (Health Insurance Portability and Accountability Act), Exceptions to confidentiality, Reporting Abuse, Duty to Warn etc. + Answer calls/texts/chats within standard service levels + Apply sound clinical judgement and consult with fellow clinical professionals when indicated + Triage calls/chats/texts based on presenting mental health and/or substance use disorder symptoms + Conduct appropriate behavioral health screenings, including ASAM, CalAIM, MCRT, suicide, and homicide (when indicated) + Provide customized, behavioral health referrals using a client centered approach + Conduct crisis work and ensure safety at all costs + Document all interaction in a succinct, clinical manner in the designated database; documentation must adhere to Dept. of Health Clinical Service (DHCS) requirements + Utilize our Central Contact Tracking Database and place Medi-Cal clients on the wait list per contractual guidelines + Ability to access and enter accurate relevant clinical information into Medi-Cal beneficiary electronic health record (EHR) + Meeting individualized performance goals + Complete mandatory ongoing continuing education and cultural training + Problem solves technical issues + Elevate operational issues to the manager + Adapt to changes and maintain flexibility as processes and policies are implemented to ensure compliance and quality standards You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Master's Degree or Doctorate within human services such as psychology, sociology or equivalent + 2+ years of post graduate degree providing direct clinical services: psychosocial assessments, individual therapy, substance use drug/alcohol treatment, case consultation with multidisciplinary team; case management; developing treatment plans with short/long-term goals; maintain confidential files; in-service trainings and discharge planning + Active and clear California License: Licensed Marriage and Family Therapist (LMFT), Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Psychologist and/or LPC. A licensed professional cannot be on probation and/or no pending corrective actions + Experience working with diverse multi-ethnic/socioeconomic populations; myriads of psychological disorders and addictions + Personal Computer (PC) proficiency and self-reports the ability to type with minimum proficiency of 45 words per minute + Able to work Sat and Sun 4:30am-3pm and Wed and Thurs 6pm-4:30am **Explore opportunities at Optum Behavioral Care.** We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment_ .

Salary Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary Under the general direction of leadership and management in the Customer Solution Center, Call Center, the Customer Solution Center Service Representative III handles provider inquiries and issue resolution of Level One (1) inquiries, this includes but not limited to, general inquiries on claims processing and status and eligibility verification. In addition, this position will provide support as-needed to members on in-bound calls as part of the larger role of "one-stop shop" service in the Customer Solution Center. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties Assist providers in response to telephonic and electronic inquiries and concerns on all products and paid/unpaid claims. Ensure that accurate information is being given to the provider in a timely manner and with the highest level of customer service. Handle Level One (1) provider inquiries this includes (but not limited to): general inquiries on claims processing, payment status and appeal and eligibility status verification. Document the interaction with the provider, including any resolution or escalation steps in the system of record for each call. Provide detailed information for each call including: Caller information; Information related to request/issue; Resolution information or escalation steps. Escalate Level Two (2) provider concerns to the Claims Department for resolution (e.g. Provider Disputes, incorrectly paid claims, payment check status, and Explanation of Benefits (EOB) requests. (50%) Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project's/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.(20%) Support the Call Center in meeting State regulatory requirements by handling member-related inbound calls. (10%) Perform special projects and ad-hoc assignments when necessary. (10%) Perform other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 2 years of experience in customer service in a high-call-volume healthcare customer service call center, including a minimum of 2 years of general claims inquiry or managed care specialty line of business experience. Customer service training in a healthcare environment. Data entry experience with the ability to type a professional minimum of 35 wpm. Skills Required: Working knowledge of Microsoft Office Suite (e.g. Word, Excel, PowerPoint, Outlook). Excellent communication skills (written and verbal). Ability to navigate multiple programs/databases while assisting each caller. Proficient knowledge in healthcare product lines, medical terminology and claims processes. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Preferred: Technical training/certificate in a technical or business school (e.g. medical billing, medical terminology, medical coding, healthcare). Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Call Center Representative, Customer Service Representative, Call Center, Claims, Data Entry, Customer Service, Insurance, Administrative

Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Representative II has advanced knowledge of healthcare and various managed care product lines, including Medi-Cal, PASC, L.A. Care Covered/Cal Medi-Connect and is proficient in medical terminology. The position responsibilities include duties such as: assist supporting queues and management with projects as needed (e.g. provide informative feedback on desktop procedures, follow-up on member inquiries, CSC Representative shadowing etc.), acting as back-up support to Call Center Leads. This position handles inbound and outbound interactions involving member eligibility verification, general provider inquiries, claim status (pre-payment), general program and administration questions for all lines of business including direct member request for I.D cards and Primary Care Physician (PCP) changes, triages calls to appropriate units or outside entities and processes payments for L.A. Care Covered members. All interactions are documented in system of record. Duties Answers incoming calls for all product lines from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base systems. (QMEIS). Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (60%) Processes payments for L.A. Care Covered members. (15%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Performs other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 1 year of customer service call center experience in a healthcare environment. Data entry experience with ability to type a minimum of 40 wpm. Preferred: Managed care or health plan experience. Previous Automatic Call Distribution (ACD) experience preferred. Skills Required: Knowledge of medical terminology. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Ability to answer a high volume of calls. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Call Center Representative, Customer Service Representative, Call Center, Data Entry, Customer Service, Administrative

Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Representative II has advanced knowledge of healthcare and various managed care product lines, including Medi-Cal, PASC, L.A. Care Covered/Cal Medi-Connect and is proficient in medical terminology. The position responsibilities include duties such as: assist supporting queues and management with projects as needed (e.g. provide informative feedback on desktop procedures, follow-up on member inquiries, CSC Representative shadowing etc.), acting as back-up support to Call Center Leads. This position handles inbound and outbound interactions involving member eligibility verification, general provider inquiries, claim status (pre-payment), general program and administration questions for all lines of business including direct member request for I.D cards and Primary Care Physician (PCP) changes, triages calls to appropriate units or outside entities and processes payments for L.A. Care Covered members. All interactions are documented in system of record. Duties Answers incoming calls for all product lines from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base systems. (QMEIS). Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (60%) Processes payments for L.A. Care Covered members. (15%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Performs other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 1 year of customer service call center experience in a healthcare environment. Data entry experience with ability to type a minimum of 40 wpm. Preferred: Managed care or health plan experience. Previous Automatic Call Distribution (ACD) experience preferred. Skills Required: Knowledge of medical terminology. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Ability to answer a high volume of calls. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Customer Service Representative, Call Center Representative, Call Center, Data Entry, Customer Service, Administrative

Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Representative II has advanced knowledge of healthcare and various managed care product lines, including Medi-Cal, PASC, L.A. Care Covered/Cal Medi-Connect and is proficient in medical terminology. The position responsibilities include duties such as: assist supporting queues and management with projects as needed (e.g. provide informative feedback on desktop procedures, follow-up on member inquiries, CSC Representative shadowing etc.), acting as back-up support to Call Center Leads. This position handles inbound and outbound interactions involving member eligibility verification, general provider inquiries, claim status (pre-payment), general program and administration questions for all lines of business including direct member request for I.D cards and Primary Care Physician (PCP) changes, triages calls to appropriate units or outside entities and processes payments for L.A. Care Covered members. All interactions are documented in system of record. Duties Answers incoming calls for all product lines from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base systems. (QMEIS). Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (60%) Processes payments for L.A. Care Covered members. (15%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Performs other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 1 year of customer service call center experience in a healthcare environment. Data entry experience with ability to type a minimum of 40 wpm. Preferred: Managed care or health plan experience. Previous Automatic Call Distribution (ACD) experience preferred. Skills Required: Knowledge of medical terminology. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Ability to answer a high volume of calls. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Call Center Representative, Call Center, Customer Service Representative, Data Entry, Customer Service, Administrative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Responsible for handling inbound calls, from providers and members in a call center / cue based environment + Conduct initial clinical assessments and determine appropriate levels of care, based on medical necessity + Explain and administer benefits according to plan descriptions for all levels of care (OP, IOP, PHP, RTC, IP) + Ability to quickly assess and meet time sensitive deadlines within the Utilization management setting + Ability to manage and resolve complex or escalated callers/issues in fast paced environment You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Master's degree in psychology, Social Work or Marriage and Family Therapy, LPCC, or PhD/PsyD + Active, unrestricted independent clinical license in the State of CA: LP, LCSW, LMFT, LPC along with CA residency + 2+ years of experience in behavioral health + Live in and be a legal resident of California for the duration of employment + Ability to work 8:30am-5pm PST + Ability to work rotating holidays + Dedicated office space and access to high-speed internet service in your home **Preferred Qualifications:** + Dual diagnosis experience with mental health and substance abuse + Experience in working in an environment that required coordinating benefits and utilizing various resources to meet patient needs + Experience with utilizing computer applications and softphone to complete all primary work responsibilities + Proficiency in Microsoft Office Suite Program (Word, Teams, Outlook, Excel, etc.) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Salary Range: $45,760.00 (Min.) - $47,823.00 (Mid.) - $55,818.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Duties The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Duties Continued The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Education Required Instills Trust Collaborates Ensures Accountability Communicates Effectively Drives Results Optimizes Work Processes Action Oriented Nimble Learning High School Diploma/or High School Equivalency Certificate Light Education Preferred Instills Trust Collaborates Ensures Accountability Communicates Effectively Drives Results Optimizes Work Processes Action Oriented Nimble Learning High School Diploma/or High School Equivalency Certificate Light Experience The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Skills The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Licenses/Certifications Required Instills Trust Collaborates Ensures Accountability Communicates Effectively Drives Results Optimizes Work Processes Action Oriented Nimble Learning High School Diploma/or High School Equivalency Certificate Light Licenses/Certifications Preferred Instills Trust Collaborates Ensures Accountability Communicates Effectively Drives Results Optimizes Work Processes Action Oriented Nimble Learning High School Diploma/or High School Equivalency Certificate Light Required Training The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Physical Requirements Instills Trust Collaborates Ensures Accountability Communicates Effectively Drives Results Optimizes Work Processes Action Oriented Nimble Learning High School Diploma/or High School Equivalency Certificate Light Additional Information The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Call Center Representative, Call Center, Data Entry, Customer Service Representative, Customer Service, Administrative

Salary Range: $45,760.00 (Min.) - $47,823.00 (Mid.) - $55,818.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Duties Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Skills Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Customer Service Representative, Call Center Representative, Call Center, Data Entry, Customer Service, Administrative

Salary Range: $45,760.00 (Min.) - $47,823.00 (Mid.) - $55,818.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Duties Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Skills Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Call Center Representative, Call Center, Customer Service Representative, Data Entry, Customer Service, Administrative

Salary Range: $45,760.00 (Min.) - $47,823.00 (Mid.) - $55,818.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities. Duties Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS. Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%) Supports robocall and ad-hoc member outreach activities as determined by business need. (15%) Perform other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience Required: At least 6 months of customer service call center experience. Data entry experience with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Skills Required: Ability to answer a high volume of calls. Knowledge of medical terminology. Must be a strong team player, punctual, and has excellent attendance record. Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities. Must be a quick learner, excellent team player and customer service oriented. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Call Center Representative, Call Center, Data Entry, Customer Service Representative, Customer Service, Administrative

Master's level cleared behavioral health, California License: Licensed Marriage and Family Therapist (LMF), Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), Licensed Professional Counselor (LPC) or Licensed Psychologist for position for the County of San Diego's 24/7 Access and Crisis Line (ACL). The ACL provides free, confidential access to behavioral health services and crisis intervention for the 3.3 million San Diegans. The ACL also provides afterhours pre-authorization for behavioral health inpatient; crisis residential and residential substance use disorder treatment. As the clinical work is done strictly by telephone, text, and chat; this position requires an incredibly unique set of clinical skills more astute than those required for face-to- face interactions as there are no visual cues from which to draw upon to help paint a comprehensive clinical picture. Clinicians need to rely on their graduate education in psychology/sociology or related field, formal clinical training, and experience to exercise discretion and clinical judgment when providing access to appropriate behavior health services and crisis work. Clinicians need to quickly triage calls/chats/texts in the queue to ensure safety and meet contractual performance standards. Must be able to work both independently and collaboratively with high precision and intensity like that of an emergency department- everyone has a crucial, time sensitive task to complete which is integral to the success of the entire operation. This is a fast-paced, clinically heavy position not for the faint of heart but equally rewarding as one can play a pivotal role in someone's journey to recover and save lives. Behavioral Health Access -Mental Health & Substance Use Disorder Treatment Services within San Diego's system of care. ACL clinician needs to quickly establish an emotional connection with the individual, identify their need(s), conduct a behavioral health screening which includes an adapted ASAM (American Substance Abuse Medicine) screening. The clinician will also conduct clinically relevant screenings such as CalAIM (California Advancing & Innovating Medi-Cal) to determine the appropriate level of care; suicide, homicide, and Mobile Crisis Response Team (MCRT). The clinician needs to recognize, properly intervene, and follow up on any risk factors. The clinician will also help provide linkage to the most appropriate type and level of care based on the collective screenings and preferences of the caller/chatter/texter. Crisis Work -Mental or Emotional Distress; Intimate Partner Abuse; Child/Elder Abuse; Suicide prevention, intervention and postvention etc. ACL clinician needs to quickly establish a therapeutic alliance, screen for risk factors, seek to help de-escalate the individual using brief solution focused therapy, motivational interviewing skills and Applied Suicide Intervention Skills Training (ASIST). Clinicians help ensure safety by using the least invasive intervention on a continuum to the most invasive, which may include initializing active rescue services as a last resort. Once de-escalated, clinicians will collaboratively work with the individual to explore the next steps and treatment options. This service meets 988 National Suicide Prevention Lifeline (NSPL) standards for risk assessment and engagement of individuals at imminent risk of suicide. ACL accepts calls from 988 to support individuals in crisis. Utilization Management Afterhours - Review behavioral health pre-authorization documentation for inpatient, crisis residential and residential substance use disorder treatment requests for Medi-Cal beneficiaries. These reviews are completed via an online review process. The documentation is completed in the County's Electronic Health Record (EHR); you must be able to access the County's EHR. A successful clinician must quickly switch between answering access and crisis calls, texts, and chats and process pre-authorizations. Shift is Sat and Sun 4:30am-3pm and Wed and Thurs 6pm-4:30am If you are located in CA, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: * Uphold and model Our Cultural Values * Adhere to all applicable laws and ethics (HIPAA (Health Insurance Portability and Accountability Act), Exceptions to confidentiality, Reporting Abuse, Duty to Warn etc. * Answer calls/texts/chats within standard service levels * Apply sound clinical judgement and consult with fellow clinical professionals when indicated * Triage calls/chats/texts based on presenting mental health and/or substance use disorder symptoms * Conduct appropriate behavioral health screenings, including ASAM, CalAIM, MCRT, suicide, and homicide (when indicated) * Provide customized, behavioral health referrals using a client centered approach * Conduct crisis work and ensure safety at all costs * Document all interaction in a succinct, clinical manner in the designated database; documentation must adhere to Dept. of Health Clinical Service (DHCS) requirements * Utilize our Central Contact Tracking Database and place Medi-Cal clients on the wait list per contractual guidelines * Ability to access and enter accurate relevant clinical information into Medi-Cal beneficiary electronic health record (EHR) * Meeting individualized performance goals * Complete mandatory ongoing continuing education and cultural training * Problem solves technical issues * Elevate operational issues to the manager * Adapt to changes and maintain flexibility as processes and policies are implemented to ensure compliance and quality standards You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Master's Degree or Doctorate within human services such as psychology, sociology or equivalent * 2+ years of post graduate degree providing direct clinical services: psychosocial assessments, individual therapy, substance use drug/alcohol treatment, case consultation with multidisciplinary team; case management; developing treatment plans with short/long-term goals; maintain confidential files; in-service trainings and discharge planning * Active and clear California License: Licensed Marriage and Family Therapist (LMFT), Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Psychologist and/or LPC. A licensed professional cannot be on probation and/or no pending corrective actions * Experience working with diverse multi-ethnic/socioeconomic populations; myriads of psychological disorders and addictions * Personal Computer (PC) proficiency and self-reports the ability to type with minimum proficiency of 45 words per minute * Able to work Sat and Sun 4:30am-3pm and Wed and Thurs 6pm-4:30am Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Salary Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Lead Service Liaison position is responsible for supporting daily management functions of the outreach team, helping ensure productivity, quality, and performance targets are met. This position serves as the subject matter expert for the execution of member and provider outreach efforts for all lines of business. This position leads and works closely with assigned team daily. This position will mentor, coach, and may provide feedback to management on performance of staff. Ensure team effectiveness and project completion. Duties Monitors and facilitates timely contact of members regarding all outreach and retention programs for all lines of business. Provides recommendations for process improvements. Monitors real-time activity and campaign management, as needed. Ensures system of record is functional to provide complete, accurate information. (50%) Assists management in ensuring staff provides accurate, timely and quality service to our members and providers, ensuring adherence to all departmental policies, procedures, and standards. Assists with special projects and campaigns that can provide feedback for membership satisfaction. Assists with campaign management functions for outreach efforts across all lines of business. (20%) Assists management in providing accurate and timely reports to senior leadership. Performs Quality Assurance functions for vendor outbound campaigns. Interfaces and collaborates with management and stakeholders within and outside of the organization to address and resolve questions, elevate areas of member dissatisfaction, and barriers to care. Assists with identifying and implementing related process and system improvements. (20%) Leads the work of assigned staff; regularly assigns and checks the work of others, providing guidance, training, and feedback on performance to department management. Assist management in the oversight of the daily office workflow, recommends enhancements to process and procedures. Guide the assigned staff in ensuring that the team's work is completed effectively. May assist in the assigning tasks and communicating project goals. Participates in team problem-solving, decision-making, and conflict resolution. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Performs other duties as assigned. (10%) Duties Continued Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Associate's Degree Experience Required: At least 2 years of customer service experience in a contact center environment, preferably in a managed care plan setting. At least 3 months of experience leading a process, program, and/or staff. Skills Required: Strong coaching and motivational skills. Proficiency with Customer Relationship Management (CRM) systems and dialing platforms. Ability to analyze data and make performance-driven recommendations. Proficiency in Microsoft Office suite. Ability to communication, conflict resolution, and motivational skills. Ability to collaborate closely with a team in a collaborative and interactive environment. Skilled in fostering teamwork and collaboration. Ability to adjust to changing circumstances within the team. Good verbal and written communication skills. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Relationship Manager, Customer Service

Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Engagement and Experience Member Advocate III serves as a high-level resource and member support specialist within L.A. Care's Customer Engagement and Experience operations. This position advocates and assists members in navigating their health plan benefits, accessing care, resolving issues, addressing waste and abuse, and connecting to community, clinical, and social services. The Customer Engagement and Experience Member Advocate III handles complex, sensitive, or escalated cases. Provides guidance to other advocates. Collaborates across departments to improve the member experience. This position plays a key role in supporting retention, satisfaction, and access to care for our underserved population. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff. Duties Assists members with complex benefit questions, care navigation challenges, grievances, access to services, and issue resolution. Conducts high-touch outreach to support vulnerable or high-risk populations, including seniors, individuals with chronic conditions, and members with unmet social needs. Serves as a subject matter expert for benefit interpretation, care coordination pathways, and service workflows. Resolves escalated inquiries from customer service, care management, and provider relations. Helps members understand coverage, Primary Care Physician (PCP) selection, referrals, authorizations, and healthcare system processes. Connects members to community resources related to housing, food, transportation, financial assistance, behavioral health, and other social determinants of health (SDoH) needs. Coordinates with cross-functional key stakeholders to remove barriers to care. Supports member engagement initiatives such as health literacy outreach, preventive care reminders, redetermination support, and quality-improvement campaigns (e.g., Healthcare Effectiveness Data and Information Set (HEDIS), California Association of Health Plans (CAHPS)). Participates in member experience programs focused on improving satisfaction, retention, and service outcomes. Documents member feedback and identifies recurring pain points for operational improvement. Works closely with cross-functional key stakeholders to address member needs. Assists with complex cases requiring multi-department coordination. Serves as a representative for Member Advocacy on workgroups or improvement projects. Accurately documents all member interactions, interventions, and referrals in the plan's systems. Escalates potential quality-of-care issues, safety concerns, or compliance risks to appropriate teams. Maintains confidentiality in accordance with Health Insurance Portability and Accountability Act (HIPAA) and managed care regulations. Supports audit readiness through timely, accurate, and complete documentation. Apply subject matter expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training and recommend process improvements as needed. Performs other duties as assigned. Duties Continued Education Required Associate's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Bachelor's Degree in Healthcare or Related Field Experience Required: At least 5 years of experience in member services, advocacy, care coordination, customer service, or healthcare navigation. Experience working with vulnerable, underserved, and culturally diverse populations. Experience resolving individual cases with regulatory state agencies. Preferred: Experience in Medicaid, Medicare, or managed care environments strongly preferred. Skills Required: Strong understanding of health plan benefits, medical terminology, and the healthcare delivery system. Excellent communication, problem-solving, and conflict-resolution skills. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Ability to handle sensitive and complex member issues with compassion and professionalism. Knowledge of community and social service resources. Proficiency with CRM systems, case management tools, and documentation standards. Strong organizational skills and ability to manage multiple priorities. Knowledge of healthcare regulations and policies and procedures. Excellent public speaking/public presentation skills. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Medicaid, Medicare, Behavioral Health, Social Services, Healthcare, Service

Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Customer Engagement and Experience Member Advocate III serves as a high-level resource and member support specialist within L.A. Care's Customer Engagement and Experience operations. This position advocates and assists members in navigating their health plan benefits, accessing care, resolving issues, addressing waste and abuse, and connecting to community, clinical, and social services. The Customer Engagement and Experience Member Advocate III handles complex, sensitive, or escalated cases. Provides guidance to other advocates. Collaborates across departments to improve the member experience. This position plays a key role in supporting retention, satisfaction, and access to care for our underserved population. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff. Duties Assists members with complex benefit questions, care navigation challenges, grievances, access to services, and issue resolution. Conducts high-touch outreach to support vulnerable or high-risk populations, including seniors, individuals with chronic conditions, and members with unmet social needs. Serves as a subject matter expert for benefit interpretation, care coordination pathways, and service workflows. Resolves escalated inquiries from customer service, care management, and provider relations. Helps members understand coverage, Primary Care Physician (PCP) selection, referrals, authorizations, and healthcare system processes. Connects members to community resources related to housing, food, transportation, financial assistance, behavioral health, and other social determinants of health (SDoH) needs. Coordinates with cross-functional key stakeholders to remove barriers to care. Supports member engagement initiatives such as health literacy outreach, preventive care reminders, redetermination support, and quality-improvement campaigns (e.g., Healthcare Effectiveness Data and Information Set (HEDIS), California Association of Health Plans (CAHPS)). Participates in member experience programs focused on improving satisfaction, retention, and service outcomes. Documents member feedback and identifies recurring pain points for operational improvement. Works closely with cross-functional key stakeholders to address member needs. Assists with complex cases requiring multi-department coordination. Serves as a representative for Member Advocacy on workgroups or improvement projects. Accurately documents all member interactions, interventions, and referrals in the plan's systems. Escalates potential quality-of-care issues, safety concerns, or compliance risks to appropriate teams. Maintains confidentiality in accordance with Health Insurance Portability and Accountability Act (HIPAA) and managed care regulations. Supports audit readiness through timely, accurate, and complete documentation. Apply subject matter expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training and recommend process improvements as needed. Performs other duties as assigned. Duties Continued Education Required Associate's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Bachelor's Degree in Healthcare or Related Field Experience Required: At least 5 years of experience in member services, advocacy, care coordination, customer service, or healthcare navigation. Experience working with vulnerable, underserved, and culturally diverse populations. Experience resolving individual cases with regulatory state agencies. Preferred: Experience in Medicaid, Medicare, or managed care environments strongly preferred. Skills Required: Strong understanding of health plan benefits, medical terminology, and the healthcare delivery system. Excellent communication, problem-solving, and conflict-resolution skills. Preferred: Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Ability to handle sensitive and complex member issues with compassion and professionalism. Knowledge of community and social service resources. Proficiency with CRM systems, case management tools, and documentation standards. Strong organizational skills and ability to manage multiple priorities. Knowledge of healthcare regulations and policies and procedures. Excellent public speaking/public presentation skills. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including * Paid Time Off (PTO) * Tuition Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Behavioral Health, Social Services, Medicaid, Medicare, Healthcare, Service

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and handles more complex pharmacy issues and respond to escalated calls from members, provider/physician's offices and pharmacies. This role will make outbound calls and enters pharmacy overrides into systems based on approved guidelines and approvals provided from clinical pharmacists. + Takes member/prescriber/pharmacist inquiry calls for benefit questions including prior authorization requests + Offers options including submission of a prior authorization request + Thoroughly researches issues and takes appropriate action to resolve them using the appropriate reference material within turnaround time requirements and quality standards + Answers and conducts inbound and outbound calls with members and provider offices to provide resolution to claims (i.e.: additional information requests and medication determination updates) + Thoroughly researches issues and takes appropriate action to resolve them within turnaround time requirements and quality standards + Assists team members often guiding them to the appropriate resolution of more complex and difficult inquiries + Participates in the training of less experienced staff, including opportunity for job shadowing + Acts as a liaison between internal departments on data gathering and problem solving while investigating problems of an unusual nature in the area of responsibility + Presents proposed solutions in a clear and concise manner + Assists with audit preparation as needed + Assists with miscellaneous special project work as assigned + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** High School Diploma / GED 2 years of experience Call center / customer service experience Experience in healthcare environment (pharmacy operations, managed care, pharmacy hospitals and or pharmacy retail settings) **License/Certification:** Pharmacy technician certification preferred Pay Range: $19.43 - $32.98 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act